Brain Tumour Survivor

Surgery spectators - Neurosurgeon Charlie Teo defends..
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Author:  kenobewan [ Thu Oct 06, 2011 6:21 am ]
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Shock, anger at surgery cuts

Tasmania's health unions are in shock as the State Government prepares to drastically reduce its elective surgery budget to rein in health costs.

Thousands of elective surgeries will be postponed as the Government works to slash the Health Department's spending by $400 million over the next four years.

The Government plans to cut $21.6 million worth of elective surgery over the next nine months.

Nurses were said to be in tears at Burnie's North-West Regional Hospital after the announcement.

The Health and Community Services Union says the head of the Launceston General Hospital confirmed 64 beds will close as a result.

Mr Jacobson says beds will also have to close at the Royal Hobart and North-West Regional Hospitals.

"That is a reduction of somewhere in the order of 20 per cent of the beds at the LGH."

"That is incredible, it is shocking and the Government, in spite of its rhetoric around keeping the patient at the centre of everything they do, really needs to have a hard think about what it is that they're doing here."

Mr Jacobson believes surgeries will be cancelled for at least six months.

"Waiting lists will blow out."

The Australian Nursing Federation's Neroli Ellis says surgical wards and much-needed hospital beds will close across the state.

"It'll be hundreds of positions to go, not just nursing. It'll be medical, it'll be general support staff.

"Right across the board now, we will see the health system decimated."

She says elective surgery will basically stop in the north-west, starting as soon as next week.

"This is a devastating announcement by the Government with a complete lack of foresight and risk management."

"It means the emergency department who is already being backed up on a daily basis now will have less access to beds.

"Every nurse at the moment is in shock and very concerned about health care and how on earth their patients are going to access health care," she said.

The Health Minister Michelle O'Byrne denies it is a dangerous move.

"There is not a clinician or hospital that would do something that was unsafe."

She says emergency surgeries will not be affected.

The Health Department projects the cuts in elective surgeries will increase to at least $58 million over the next three years.

The Opposition's Jeremy Rockliff says 12,000 Tasmanians will now miss out on elective surgeries.

"I'm not sure how you could rip $60 million out of elective surgery and not impact on patient care."

"People, right now in Tasmania, are in severe pain on a waiting list, 7,700 people are waiting, this is going to blow out to 20,000 people," he said. ... ection=tas

Author:  kenobewan [ Mon Oct 24, 2011 6:28 am ]
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Hugo Chavez Demands Healthy Cancer Outlook

Hugo Chavez's cancer treatment is right on track and he is in optimal health, according to his medical team.

But the Venezuelan dictator wouldn't accept any other prognosis. According to a report in the Wall Street Journal, Salvador Navarette, who at one point was among Chavez's personal physicians, wrote an open letter in a Venezuelan opposition newspaper that said the country's leader wouldn't live longer than two years because of his aggressive cancer. After the letter published, the physician received a prompt visit from the Venezuelan intelligence service and then fled the country. He has since told Mexican media it was an unwanted, abrupt departure, but hasn't offered many more details.

Navarrete said he meant no harm from the prognosis, he simply wanted to let the country know the grave danger Chavez is in. He is quoted in the Wall Street Journal saying "I am not a traitor."

To combat Navarrete's message, Dr. Fidel Ramirez, a member of Chavez's medical team, went on a national broadcast Saturday to assure the country Chavez was healthy and had an excellent outlook, according to a report from the Washington Post.

Chavez hadn't made public what kind of cancer he suffers from, only admitting he has been receiving treatment since June, mostly in Cuba. On Saturday, though, Dr. Ramirez confirmed it was a pelvic tumor, but said it's removed and is no longer an issue.

Navarrete claims it's a type of bone cancer, and Chavez has an aggressive pelvic tumor known as sarcoma. Navarrete hasn't treated the dictator since his cancer diagnosis, but treated him in the past and says he gathered his information from relatives and other physicians of Chavez.

A prolific Tweeter, since his treatment started, Chavez has taken to the social media outlet to tweet messages of vitality and cheer to ensure his citizens he's not deteriorating. ... 10-23-2011

Author:  kenobewan [ Sun Apr 22, 2012 7:41 pm ]
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Pilot study details new method to diagnose brain cancer without surgery

A team led by researchers at Brigham and Women’s Hospital have devised a new, less-invasive technique that could one day be used to diagnose brain cancer and monitor a tumor’s response to treatment, without surgery.

The pilot study, published in the journal Neuro-Oncology, still needs to be tested more rigorously before it is used in patients, according to Anna Krichevsky, a neurobiologist at the Center of Neurologic Diseases at the Brigham, who led the research. But the promising technique might provide a powerful new tool to monitor the course of a brain cancer and how a tumor responds to treatment, and to give clinicians a better way to distinguish between different types of tumors.

In the study, researchers focused on molecules that essentially act like genetic thermostats, regulating the activity of different genes. Those molecules, called microRNA’s, play a role in cancer, and the researchers -- a team that also included clinicians and scientists from the Georg-August University in Germany and the University of California, San Diego -- looked for seven tell-tale molecules in samples of cerebrospinal fluid from 118 patients for whom they also had brain tumor samples. Researchers found that microRNA’s provided a way of recognizing and differentiating glioblastoma, brain cancers that had metastasized from breast and lung cancers, and tumors in remission. They also found hints in a smaller subset of the patients that the tool could be used to monitor disease progression in a tumor.

The work is being patented. Krichevsky said that she hopes to follow up the pilot study by testing the technique more extensively. ... index.html

Author:  kenobewan [ Sun Apr 29, 2012 8:42 am ]
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Prostate cancer surgery 'has no significant survival benefit', study suggests

Research, which has not yet been published, has indicated the standard surgical treatment did not extend the life of cancer sufferers significantly any more than “watchful waiting”.

The results, reported by the Independent newspaper, are said to have left experts “shaken” after showing the common treatment did not necessarily improve lives.

One specialist, who did not want to be named, told them: “The only rational response to these results is, when presented with a patient with prostate cancer, to do nothing.”

The Prostate Intervention Versus Observation Trust (PIVOT), led by Timothy Wilt, began in 1993 with 731 subjects, following them over 12 years to monitor their health.

It compared cancer patients who had their prostate gland removed with those monitored by “watchful waiting”, to establish how their treatment affected survival rates.

It found those who underwent the operation had less than a three per cent better chance of survival than those who had no treatment; a figure which could have arisen by chance.

When the results of the study were reported at a meeting of 11,000 experts at the European Association of Urology in Paris, they were met with “stunned silence”, the newspaper claimed.

Prostate cancer, which affects 37,000 men in the UK every year, is the most common cancer suffered by men.

But despite causing 10,000 deaths per year, it is slow growing in half of all cases, with sufferers often dying of another illness before it becomes fatal.

The standard surgery, known as radical prostatectomy, carries risks including impotence and incontinence.

Ben Challacombe, consultant urologist at Guys and St Thomas’ NHS Trust, told the newspaper he did not agree the response to the results should always be to "do nothing".

He said that for older, low-risk men, they would already "offer milder treatment such as radiotherapy or watchful waiting" and added: "We are better than the US in putting men on surveillance.”

Dr Kate Holmes, head of research at The Prostate Cancer Charity, said they were aware of the findings and awaited the full published results.

She said: “Early data from the PIVOT trial certainly suggests that surgery to remove the prostate does not provide any significant survival benefit for men with low to medium risk prostate cancer.

“However, these findings are from a large ongoing trial, and we look forward to seeing the full published results which could help men in future to make more informed decisions about treatment.

““This trial also highlights how important it is that research into improved diagnosis, staging and treatment of prostate cancer is sustained if we are to take treatment for the disease to the next level.

“We have been working with existing methods for far too long and it is vital that investment continues if we are to reduce the number of men who die from this disease every year.”

The charity added around 250,000 men are currently living with prostate cancer in the UK, with one man dying from it every hour. ... gests.html

Author:  kenobewan [ Sun May 06, 2012 7:23 am ]
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Global remedy to a local affliction

More Australians are travelling overseas to countries such as India and Thailand for surgery as globalisation makes private medical care more affordable and waiting times lengthen back home, writes Jim O'Rourke.

Thousands of Australians who are frustrated at waiting up to 14 months for elective surgery, or cannot afford a private hospital, are travelling to developing countries for much cheaper operations as part of a booming $60 billion international ''medical tourism'' industry.

Medical tourism ''facilitators'' based in Australia say they can arrange procedures for major surgery - joint, spine, brain and heart - in specially designed ''medi-cities'' for international patients who pay a fraction of what they would spend at home, even after airfares.

Australians are travelling to India, Thailand, Singapore, South Korea, Turkey and the Middle East for treatment to avoid public hospital surgery queues, which are as long as 420 days for non-urgent elective operations in NSW.

While Australian doctors warn that such patients are taking a risk with their health, the globalisation of medicine is making the journeys too tempting for many patients. A total hip replacement that can require a wait of up to 12 months in a NSW public hospital, or cost about $25,000 at a private hospital, can be booked and completed within a couple of weeks for $9000 in India - a price which includes airfares and accommodation in a guesthouse during recuperation.

With the strong Australian dollar, patients can save as much as 70 per cent on some procedures, but medical facilitators also offer extended payment plans for patients.

There are no official figures collected on the number of Australians who travel overseas for surgery, but one local company, Global Health Travel, says it makes arrangements for more than 800 patients a year to travel to a choice of eight countries. Its founder, Cassandra Italia, said her company could have a patient on an operating theatre table in a modern Indian or Thai hospital for a full hip replacement within a week of making a booking.

Medi Makeovers, which specialises in cosmetic procedures and dental work, arranges for about 400 Australians to visit Thailand each year to take advantage of cut-price medical care. Another operator, Hemani Thukral, who runs MyMedicalChoices, sends her clients to surgeons in India, many of whom have been trained in Britain and the US, she said.

Dr Thukral, who has a medical degree from India, has business relationships with some of her home country's biggest private hospitals and clinics in Delhi, Mumbai, Bangalore and Chennai.

''One of the surgeons I deal with has done 13,000 knee replacements,'' she said. ''Australians can be assured that the treatment and facilities are on par or better than they get here.''

Dr Thukral said the hospitals she dealt with were certified with international healthcare accreditation bodies. The hospitals are based in medi-cities - large medical campuses housing a variety of specialty clinics - built to attract international patients and offering special services including visa assistance, express check-in through dedicated international patient's lounges, concierges and language interpreters.

''This is offering Australians a fresh hope, rather than living with the pain and inconvenience, especially for orthopedics problems,'' Dr Thukral said.

''For all non-life threatening surgeries, overseas medical treatment is a viable option. People come to me who have had chronic pain for years, their lifestyles are debilitated and they can't do the things they enjoy. We give them options. We help them get from door to door, from the airport, to the hospital, to their guesthouse to recover.''

The Deloitte Centre for Health Solutions, an arm of the multinational Deloitte accountancy firm, said medical tourism has become a $60 billion worldwide business and is growing at more than 20 per cent a year. India alone attracts more than 700,000 medical tourists annually. Thailand attracts close to a million, Singapore 500,000, Malaysia 400,000 and the Middle East, including Israel and Dubai, 265,000.

The health travel consumer organisation Patients Beyond Borders said about 5 million patients a year become medical tourists, spending an average $US3000 per surgery and thousands more on airfares and accommodation.

While increasing numbers of people are paying for medical and accommodation packages for surgical procedures, the market is still dominated by travellers seeking cheaper dental treatment or cosmetic surgery.

Dr Thukral said dental, eye, and cosmetic surgeries in Australia cost three to four times as much as in India. A major operation, she said, such as robotic heart surgery in India, could be arranged for about $13,500, compared with $60,000 in Australia. The costs were lower in India because the capital and labour costs were well below those in the developed world, she said. ''And the medical devices, implants and medications are cheaper than in Australia.''

But Australian doctors remain concerned about poor surgical results and inadequate medical care after a procedure.

The Australian Medical Association's NSW president, eye surgeon Michael Steiner, said most specialists had seen patients who had travelled overseas for treatment. ''And we've all seen, from time to time, very significant problems as a result,'' he said. ''They think surgery here is more expensive, but we have extremely high standards and very highly qualified people.'' He said continuity of care was also important.

Latest official NSW government figures show that some patients were forced to wait up to 420 days to be admitted to a public hospital for non-urgent elective operations such as hip replacements. The median waiting time for non-urgent surgery across more than 80 NSW public hospitals and clinics was 212 days.

The chairman of the Royal Australasian College of Surgeons' professional standards committee,

Graeme Campbell, said he had heard anecdotally there had been an increase in the number of Australians having surgery overseas. ''If people are going abroad for mainstream surgery that is provided in the public hospital system, then that's a concern,'' Dr Campbell said.

He said there was ''no doubt'' that patients in Australia faced ''significant waits'' to see a surgeon: ''The fact that people are seeking an overseas alternative does reflect deficiencies in the public hospital system.''

He advised those who were contemplating surgery overseas to find out about the backgrounds of their surgeon and anaesthetist, and the reputation of the hospital or clinic.

''Many of those countries welcoming medical tourists have parts of their health systems that are of the highest quality. The best of their surgeons are at least as good as the best of our surgeons, but there is a greater variability [in service],'' Dr Campbell said.

''Ultimately you've got to work out, is it worth the risk?''

The Sun-Herald asked the Health Minister, Jillian Skinner, why NSW residents were opting for surgery overseas and why elective surgery waiting lists were so long.

A ministry spokesman said seeking treatment as a private patient, either within Australia or overseas, was a matter of individual choice.

Ms Italia said she saw a gap in the market for patients waiting for elective surgery.

''People tell me they are on an 18-month waiting list, they can't work, they can't take care of their children, they are at their wits' end,'' she said.

''We can get them onto the operating table within a week, as long as their medical records are up to date, and we can book them a flight. There are no waiting times, really.''

Global Health Travel also offered clients medical travel insurance which covered complications for up to six months after the treatment. ''The biggest risk is not infections or complications, it's getting a DVT [deep vein thrombosis] on the plane on the way home,'' Ms Italia said. ... z1u25dlxPf

Author:  kenobewan [ Mon May 07, 2012 5:51 am ]
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Is your mobile phone REALLY killing your brain?

FATAL brain cancer is on the rise and could be caused by radiation from mobile phones, which would mean we're heading for devastation "on a scale never before witnessed in history".

Or there may be nothing to worry about.

Right now, no one knows for sure – and Dr Charlie Teo, one of Australia's top neurosurgeons, says some people are too afraid to find out because of the enormous consequences.

Some studies have found there is no link between mobiles and brain cancer. Others have found a link. Dr Teo told that studies that found no link were usually at least partly funded by telecommunications companies – and that the telcos have in the past refused to release records of phone usage that would allow a more robust study to be done.

The largest study done, the international and partly telco-funded Interphone study, found phones were safe – unless you are a "heavy user", or a child (children were not included in the study).

"(Brain cancer) is a terrible disease, it's the most lethal cancer known to mankind. It kills young people and it appears to be affecting more people than it did ten years ago. I believe there may be a link between mobile phones and brain cancer," Dr Teo said.

"Finding a definite link would be devastating – and the telecommunications companies are too afraid to find out."

Dr Teo – whose opinion is published in full on The Punch today – thinks we need to find out for sure, and soon.

"Why wait until half the world's population has brain cancer?" he asked.

He also went to great pains to emphasise that there may not be a link; that he is not a radiation expert, and that he is not a zealot who wants to get rid of mobile phones. But he has looked at all the available evidence, at least a third of his patients' tumours are in the area of the brain near the ear, and he wants to find out what is going on.

The Cancer Council NSW also says more research is always good, but they add that in general people shouldn't get too uptight. Chief executive officer Dr Andrew Penman said it was "difficult to prove that mobile phones cause cancer but even more difficult to prove they don't cause cancer".

He says the "real world" shows that if there was any effect from phones it would be "very small".

Dr Penman says any rise in brain cancer incidences are in older people, and that because large studies such as the Interphone study have not found a link there is no need for people to panic.

"It's fine to be aware of the debate, but as the evidence has accumulated the level of alarm and concern … that prompted warnings about use in young children … has abated," he said.

"People tend to cast around for exotic causes of cancer they can control – but the big thing is tobacco, lack of exercise, obesity, sun exposure, the use of hormone replacement therapy. We know those things have a big effect, and you can actually do something about those."

Dr Penman says there is no need for people to change their behaviour.

Dr Teo says he personally minimises his usage and always uses a hands-free kit.

The World Health Organisation says the non-ionising radiation emitted by phones is possibly carcinogenic and recommends hands-free or texting.

And in the instructions for iPhones and Blackberries lurks a warning to keep phones slightly away from your body.

Australian Mobile Telecommunications Association Chief Executive Officer Chris Althaus said AMTA rejected "Dr Teo's baseless claims of alleged improper industry influence over research into mobile phone health and safety".

He said while they respected his work and acknowledged his right to express his opinion, expert opinion and the weight of evidence showed there were no adverse health effects from mobile phone use.

He said the industry was committed to supporting expert research to help consumers make informed choices, that funding was provided under strict protocols – and that sometimes governments made funding conditional on some funds coming from industry.

Mr Althaus also said the industry had cooperated fully with researchers. ... 6348144071

Author:  kenobewan [ Thu May 10, 2012 6:27 am ]
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Size matters, even when it's just your brain

The world's largest study of the human brain, involving more than 200 scientists worldwide, found genes that affect brain size may play a part in intelligence and memory function.

Dr Margie Wright from the Queensland Institute of Medical Research, which contributed to the study, said brain size can not only have an effect on thoughts and behaviour, but also intelligence.

The study was put together by combining brain scans and genetic data from 21,000 people worldwide.

Dr Wright said one gene showed a strong correlation with overall brain size while another influenced the size of the brain's hippocampus, which is involved with memory.

Dr Wright said the gene involved with the hippocampus influences the rate at which this part of the brain shrinks with age.

People with dementia often show pronounced shrinkage in the hippocampus so further investigation to see if there are genetic links to dementia will be worthwhile, she said.

The hippocampus is also reduced in people with schizophrenia and major depression.

A separate study at QIMR showed those with larger brains scored slightly higher on a standardised IQ test.

Dr Wright said the global brain study, which has created the world's largest database of brain imaging results, could be a stepping stone for more work into the brain's genetics and disorders.

"The effects of the two genes on brain size are very small and the links to cognitive function are subtle," Dr Wright said.

"However, as we can lose up to 10 per cent of our brain volume in later life, these results are quite significant in people with the genetic variant that increases shrinkage."

These individuals could be more vulnerable to factors such as poor diet, excessive alcohol consumption, or little exercise, she said. ... 6351428024

Author:  kenobewan [ Sat May 12, 2012 6:37 am ]
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Taiwan treats Vietnamese woman with ageing disorder

TAIPEI — A Vietnamese woman suffering from a rare premature ageing disorder has been treated in Taiwan, doctors said Friday.

Nguyen Thi Ngoc Mai, 28, began experiencing premature ageing when she was 10 years old but was unable to get proper treatment due to financial difficulties, doctors said.

Nguyen had the appearance of a 70-year-old, walking difficulties and other health problems before coming to Taiwan in April, said doctors at China Medical University Hospital in central Taiwan.

She was diagnosed with the rare ageing disorder Werner syndrome, and underwent plastic and other surgeries to rejuvenate her appearance and treat skin and lung conditions, they said.

Doctors said she marked the first treatment case of premature ageing in Taiwan and that she is expected to maintain her improved condition by taking medications and avoiding the sun.

"I feel like I am being reborn and there are hopes in my life again," she said through a translator in Taipei. ... 3c33a4.841

Author:  kenobewan [ Wed May 16, 2012 7:52 am ]
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Safer Kidney Cancer Surgery Under-Used for Poorer, Sicker Medicare & Medicaid Patients

Newswise — DETROIT – An increasingly common and safer type of surgery for kidney cancer is not as likely to be used for older, sicker and poorer patients who are uninsured or rely on Medicare or Medicaid for their health care, according to a new study by researchers at Henry Ford Hospital.

The treatment, partial nephrectomy (PN), involves surgically removing only the diseased portion of a cancerous kidney, leaving the unaffected part to continue to function.

Standard treatment for small kidney tumors has traditionally been radical nephrectomy (RN) – surgical removal of the entire kidney, part of the ureter, the adrenal gland, and some surrounding tissue.

The less-extreme PN became possible with improvements in 3D scanning technology, and not only offers obvious advantages over RN, but earlier studies have found that it results in an overall drop in related cardiovascular complications and death.

The results will be presented this week at the American Urological Association Annual Meeting in Atlanta.

The Henry Ford study looked at 375,986 kidney cancer patients from throughout the U.S. who underwent either PN or RN from 1998 to 2009. Of those, 63,670 were PN patients.

During the study period, researchers found that the rate PR grew nearly five times, from 6 percent of patients to 28 percent, says Quoc-Dien Trinh, M.D., a Fellow at Henry Ford Hospital’s Vattikuti Urology Institute and lead author of the study.

Most kidney cancer patients today can be treated with this kidney-saving technique, which reduces the chance of long-term kidney failure. Another advantage is that if something happens to the patient's other kidney, there is still one in reserve.

But the Henry Ford study also found that while PN is becoming more common, it is not being used to treat certain patients for other than medical reasons. The researchers learned that rates of PN dropped in patients who:

• Are older and have additional diseases or disorders
• Have no insurance or rely and Medicare and/or Medicaid for their health care
• Live in lower-income zip codes
• Are treated in lower-volume, non-teaching hospitals

There are several possible reasons for these disparities, Dr. Trinh says, although they’re mostly conjecture because available data doesn’t provide the information to test them.

“We couldn’t adjust for such things as disease characteristics like tumor size, grade or location,” he explains. “Also, it’s possible that these patients have inferior access to care, so present with worse disease, when partial nephrectomy isn’t feasible.

“However, it is also entirely possible that patients within this bracket are treated at hospitals that don’t have the proficiency to perform this advanced surgical technique, therefore putting these patients at risk of the well-documented, long-term effects of radical nephrectomy.”

If the disparities exist because of limited access, “then mechanisms need to be implemented to ensure that these patients receive higher quality care, and that they receive the appropriate treatment, namely partial nephrectomy, whenever possible,” Dr. Trinh says. “This has been shown in all sorts of medical procedures and specialties.

“We have to change the way insurance is distributed and how health care is delivered. But this is easier said than done.” ... d-patients

Author:  kenobewan [ Thu May 17, 2012 7:46 am ]
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Patients forced into repeat surgery over faulty hip implants

MORE than 1000 patients have had to undergo repeat hip implant surgery as new figures show a dramatic rise in the failure rate of once-popular implants.

The federal government has announced a crackdown on suspect joint prostheses as latest results from a national orthopaedic registry reveal a cumulative failure rate for two related products of 25 per cent over seven years - about five times higher than average.

A Health Department spokeswoman revealed Australia has joined an international investigation into the metal implant's emission of toxic heavy metal residues into the blood stream.

The government's tougher stance on suspect implants follows months of bitter criticism from victims that the government should have acted earlier to withdraw the two failure-prone Johnson & Johnson DePuy ASR hip implants.

The company says it has paid $45 million to reimburse the costs of affected patients and had so far dealt with more than 4200 calls for help from individuals in Australia and New Zealand.

The Health Department has disclosed plans to take more active measures to ban suspect implants after experts assess performance on the basis of national records on joint replacements.

Advisory groups would ''identify devices which are performing with worse results than comparable devices'' and should not to be covered by government and health insurance payments, the spokeswoman said.

Australia was the first country to withdraw the ASR implants from use in December 2009, although evidence of problems had emerged three years earlier in the national registry of joint replacement outcomes.

Latest available figures as at this month showing a revision or failure rate of the ASR products at 25 per cent was likely to get worse on the basis of British experience, Graham Mercer, the president of the Australian Orthopaedic Association, told the Herald.

But a leading critic of some surgeons' performance on the issue, Bob Lugton, said the government action could offer a solution to stop surgeons using high risk hips. Mr Lugton, who has been disabled after his hip implant failed, said some surgeons had continued to use ''high risk'' hips and the Orthopaedic Association had been unable to stop them.

A Senate committee in November had recommended the government act urgently to provide more information to patients and doctors and to investigate the impact of cobalt and chrome emitted by the metal implants.

''Many patients are suffering abnormal health changes that are impacting badly on their lives and with the numbers of those affected growing into the thousands it is about time some action was taken by surgeons, government and the orthopaedic industry to study the effects of high cobalt and chromium serum levels,'' Mr Lugton said.

The independent Senator Nick Xenophon, who campaigned for the Senate inquiry, said the delay in providing more support for patients ''is an insult to those patients who have suffered enormously as a result of faulty devices and poor administration which could have been avoided''.

The Greens Senator Richard Di Natale called for the Therapeutic Goods Administration to prevent a repeat of the hip implant affair which had left people sick with metal leaching into their joint cavity, resulting in permanent disability for many. ... 59346.aspx

Author:  kenobewan [ Sat May 19, 2012 7:10 am ]
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Patients left fuming over hip implant failure rate

THE government's failure to promote patient interests in the wake of what is unfolding as Australia's worst orthopaedic debacle has triggered an outcry from patient and health groups.

After the disclosure this week that one in four Johnson & Johnson DePuy ASR hip implants have failed - affecting more than 1000 patients - the Health Department omitted mention of patient safety in its response, while advocating care in the treatment of product suppliers.

Asked when and how the authorities would introduce tighter safeguards on suspect devices, a spokeswoman said any decision needed to be soundly based ''and fair to all parties''.

Device suppliers would be given ''opportunity to respond to concerns about performance of particular devices''. No reference was made to patient interests in an original statement.

It was only after the department was asked why supplier interests were being given more attention than the patients that the spokeswoman said public health and welfare got prime consideration. ''The TGA does not favour the interests of sponsors over patients,'' she said.

Bob Lugton, 68, a victim and patient advocate, said: ''The government's only consideration should be for the patients' safety.

''To suggest that safety is being compromised by thoughts of 'fairness' to any party other than the patient is immoral.''

Mr Lugton said the orthopaedic surgeon national registry showed more than 15,000 patients had received a prosthesis categorised as having a ''higher than anticipated failure rate''.

The Australian Orthopaedic Association's national joint replacement registry shows in its latest available figures that more than 30 hip and knee implants were still being used in 2010 despite being shown in two previous years to have experienced a higher than average failure rate.

A campaigner for tougher regulation and a health fund chief, Michael Armitage, said the department's handling of this matter was ''appalling''.

Dr Armitage, the chief executive of Private Healthcare Australia, said the Health Minister, Tanya Plibersek, was ''condoning'' the continued use of failure-prone prostheses by not taking urgent action to remove them.

The Health Department said an expert orthopaedic group had assessed the high-failure rate devices identified and still used. In all but one published case, the experts advised continued observation of such implants ''without taking regulatory action, due to uncertainty regarding the factors causing the increased revision rate''. Updated information would be referred to the experts in June.

The Australian Orthopaedic Association opposes publishing details of implant performance earlier. It says this creates ''unnecessary public alarm'' by ''misinterpretation'' of figures. But injured patients wish they had heard the ASR news earlier.

Diana, from Melbourne, who did not want to give her surname, said her partner, Harold, 84, only became aware last year of the widespread problems with his model hip implant. She accused the government and surgeons of ''disgusting inactivity'' in failing to alert patients of the problems earlier.

Harold began experiencing pain and mobility problems about six months after his metal hip was fitted in 2007.

Michele Steger, 52, of Turramurra, has had to undergo three implant operations and said she was exasperated by the lack of evidence of efforts to prevent repeats of the ASR debacle. ... 1yw14.html

Author:  kenobewan [ Sun May 20, 2012 8:33 am ]
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Breast surgery in cancer error

Health bosses have ordered an urgent investigation into how a woman was wrongly diagnosed with cancer and had her breast removed.

The woman's test results were switched with another patient who has since been given the heartbreaking news that she has breast cancer.

The Herald on Sunday understands the women, both from the Otago region, had biopsies after mammograms revealed suspicious lesions.

Their specimens were sent to Southern Community Laboratories, which tested the tissue samples for signs of cancer.

As a result, one of the women was diagnosed with breast cancer and subsequently had a breast removed. The other was informed of a negative result. They were later told the specimens had been switched and both patients had been misdiagnosed.

Southern District Health Board, already under fire over delays in cancer diagnosis, said a review into testing procedures was underway.

The lead surgeon of BreastScreen Aotearoa at the Southern DHB, Michael Landmann, described the botch-up as "sinister" but would not go into details about the case.

"[The review] will come up with a result that will change something in pathology, such as how the labels are stuck on, or something like that," Landmann said.

"This is a serious, sinister and very important thing to check."

However, Landmann said the error was "unusual" and had slipped through the cracks of what were normally safe and accurate processes.

"The fact that millions of people get through without any of these things happening is already an indication of how far down the track we are on making things safe."

He said women were asked to check their specimen before it went to the laboratory to help avoid misdiagnosis errors.

"These women would have had the specimen in front of them and they would have confirmed that the label on the specimen was their name. It then would have gone to the lab, so the women can't make it any safer themselves."

Dunedin School of Medicine associate professor Brian Cox was baffled over how the error occurred.

"There needs to be a high level of accuracy in what goes into the database system," Cox said.

"When you're screening, there is a large number so the accuracy has to be at a very high level."

Southern Community Laboratories pathologist Peter Fitzgerald said the laboratory had written a report to help the Southern District Health Board review but refused to comment further.

ACC lawyer Peter Sara advised both women to lodge treatment injury claims with ACC for compensation.

The DHB faced criticism over delays in diagnosing cancer in 28 women between 2007 and 2010.

Chief medical officer Dick Bunton said a review involving three institutions was expected to take about another one to two weeks.

Mercy Hospital chief executive Richard Whitney said both his and Dunedin Hospital had "an interest" in one of the women.

"We have a large number of patients that go through the institution every year and on occasion there are issues that come up." ... d=10807061

Author:  kenobewan [ Wed May 30, 2012 7:25 am ]
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Tumours 'double' in size as patients wait for surgery

SOME cancerous tumours are likely to double in size during the two-month or longer waiting times many patients are facing for surgery in public hospitals.

Cancer surgery waiting times were published for the first time on the MyHospitals website yesterday and show the median waiting times -- the number of days in which half of all patients at a particular hospital are operated on.

The data from the Australian Institute of Health and Welfare shows while half the women with breast cancer treated in major city hospitals generally have their surgery within one and three weeks, half the men suffering prostate cancer are waiting from between 40 and 50 days.

At Sydney's Royal North Shore Hospital, half of those who had prostate cancer surgery had to wait more than 63 days, while at Gosford on the NSW central coast, the figure was 77 days.

Half the kidney cancer patients in regional hospitals are waiting more than 30 to 39 days for surgery, while at Port Macquarie Hospital on the NSW mid-north coast the wait was more than 61 days for half the patients.

Half of the bladder cancer patients at the Peter McCallum hospital in Melbourne had to wait more than 64 days, and half those requiring gynaecological cancer surgery at Gosford Hospital had to wait more than 70 days. At Queanbeyan, it was 59 days.

Health Minister Tanya Plibersek said the time patients waited for surgery could make a critical difference to their wellbeing and she looked forward to national benchmarks being developed against which each hospital's performance could be compared.

Medical Oncology Group chairman Gary Richardson said cancerous tumours were likely to double in size over two months and the long hospital waits were unacceptable.

"The dogma taught in oncology is that you want to treat as soon as possible," Associate Professor Richardson said.

However, North East Melbourne Integrated Cancer Service director Paul Mitchell said the AIHW figures represented a mixture that included some very slow-growing tumours and pre-cancerous cases, where a wait of a few months was not a problem.

"For very urgent cases, where the cancer is growing quickly, it is a different story," he said. His own experience in public hospitals was there was no across-the-board waiting time problem.

Professor Richardson said the reason breast cancer patients were treated more quickly was because the surgery was usually quick and easy and could often be performed without the need of an overnight hospital bed.

Bowel, lung, bladder and prostate cancer surgery took much longer and patients might need a hospital bed for up to two weeks as they recovered. ... 6373038379

Author:  kenobewan [ Thu May 31, 2012 8:08 am ]
Post subject: 

Surgical robots to take over operating theatres

Scientists and doctors are using the creeping metallic tools to perform surgery on hearts, prostate cancer, and other diseased organs. The snakebots carry tiny cameras, scissors and forceps, and even more advanced sensors are in the works. For now, they're powered by tethers that humans control. But experts say the day is coming when some robots will roam the body on their own.

"It won't be very long before we have robots that are nanobots, meaning they will actually be inside the body without tethers," said Dr Michael Argenziano, the Chief of Adult Cardiac Surgery at New York-Presbyterian Hospital and Columbia University Medical Centre in New York.

Argenziano was involved with some of the first US Food and Drug Administration clinical trials on robotic heart surgery more than 10 years ago. Now he says snake robots have become a commonly used tool.

"It's like the ability to have little hands inside the patients, as if the surgeon had been shrunken, and was working on the heart valve," he said.

But Argenziano and experts in robotics say the new creations work best when they're designed for specific tasks.

"The robot is a tool. It is no different in that sense than a scalpel. It's really a master-slave device," he said.

Howie Choset has been researching and building robots, particularly snake robots, at Pittsburgh's Carnegie Mellon University for years.

Choset believes snake robots help reduce medical costs by making complex surgeries faster and easier. Choset says his new design is smaller and more flexible than earlier models: The diameter of the head is less than the size of a dime.

The size of surgical robots allows surgeons to operate with far less damage to the body, helping the patient heal faster. For example, instead of opening the chest up during heart surgery, a small incision is made, and the robot crawls inside to the proper spot.

Dr Ashutosh Tewari, of Cornell University Medical Centre, has used robotic tools to perform thousands of prostate operations. He said the precision of the tiny robotic tool is vital not just to cutting out cancerous tumours, but to seeing exactly what nerves to leave intact.

Tewari said the variety of sensors available for surgical robots keeps expanding, even as they get smaller. He said they might one day be able to test chemicals or blood in the body, or even the electrical connections in nerves.

Choset has also built larger snake robots designed for search and rescue, or just exploration. They can climb poles or trees and then look around through a camera in the head, and slither through places humans can't reach.

"We sent our snake robots into these caves off the coast of the Red Sea to look for evidence of ancient Egyptian ships," he said.

Another expert at Carnegie Mellon stresses that there's still an enormous gap between humans and even the most high-tech robots.

Manuela Velosa noted that robots have been built that excel at one or two tasks but not at the variety humans perform without even thinking.

Velosa has been building robots that ask humans for help when they don't know what to do, as well as teams of robots that play soccer against each other. During one game against robots from another university, the Carnegie Mellon team scored on a particular play. That sent a positive signal to the robot's computers, which are designed to reward success.

Her robots tried the play again and scored again. It turned out they had discovered a programming flaw in the other team, just like some sports teams find a flaw in their opponents.

"It was programmed by me, but it looked to me as if they learned," she said. "I believe we are much closer to having robots be able to coexist with humans. The beautiful thing is you see the robots learning." ... d=10809629

Author:  kenobewan [ Thu Jun 14, 2012 6:43 am ]
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Kerri-Anne delays cancer surgery for TV finale

THE woman who has rolled with so many punches in her career since she first appeared on Australian television screens at 13 now faces "the fight of my life".

Kerri-Anne Kennerley, 58, a much-loved and inspirational figure to a generation of Australian women, has been diagnosed with breast cancer following the discovery of a small lump in her right breast.

"I never thought I was the crying kind, but guess what, I was wrong," she has said of the moment she was told at Sydney's Mater Hospital that a mammogram, ultrasound and biopsy confirmed she had cancer.

"It's like I have two people in my head. One is logical and goes: 'OK, what's the plan? The odds are in our favour, let's not get ahead of ourselves'. The other one is screaming and being an emotional lunatic."

The former host of The Midday Show on the Nine Network and a contestant in the current Network Seven series Dancing With the Stars made the announcement in New Idea magazine.

She has delayed surgery and treatment for five days so she can appear on the grand finale of the dancing show. "I couldn't possibly miss all that fun, I'm in need of a bit of fun," she said.

"John (Kennerley, her husband) and I don't wallow, we don't do deep and meaningful, we've gone into problem-solving mode. I will know more after I have an MRI this week.

"I must say all this is bloody inconvenient, and it's funny how much the vanity factor kicks in," she confessed.

"I hate the thought of losing my breast -- I've explained that to my doctor very, very emphatically -- or even losing my hair through chemotherapy." ... 6391666648

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